G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.
Case Study 1 Questions: osteoarthritis and osteoarthrosis
Define osteoarthritis and explain the differences with osteoarthrosis.
List and analyze the risk factors that are presented in the case that contribute to the diagnosis of osteoarthritis.
Specify the main differences between osteoarthritis and rheumatoid arthritis, and make sure to include clinical manifestations, major characteristics, joints usually affected, and diagnostic methods.
Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
How would you handle the patient’s concern about osteoporosis? Describe the interventions and education you would provide to her regarding osteoporosis.
500 words, 2 cited sources, APA format osteoarthritis and osteoarthrosis
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time
- Osteoarthritis is a degenerative joint disease that occurs when the cartilage that cushions the ends of bones wears down over time, causing pain, stiffness, swelling, and reduced joint function1. Osteoarthrosis is another term for osteoarthritis, which means joint degeneration2. The terms are often used interchangeably, but osteoarthritis is more commonly used in current literature3.
- The risk factors for osteoarthritis include older age, sex (women are more prone), family history, obesity, joint injury, overuse of joints, bone deformities, lack of exercise, and smoking145. In the case presented, the patient has several risk factors, such as being a postmenopausal woman, having a family history of osteoarthritis, being overweight, having a history of knee injury, and being physically inactive.
- Osteoarthritis and rheumatoid arthritis are two different types of arthritis that can cause joint problems, but they have different causes, symptoms, and treatments. Osteoarthritis is caused by wear and tear of the cartilage, while rheumatoid arthritis is caused by an autoimmune attack on the synovium, the lining of the joints67. Osteoarthritis usually affects the weight-bearing joints, such as the knees, hips, and spine, and the joints of the hands and feet, while rheumatoid arthritis usually affects the small joints of the hands and feet, as well as the shoulders, elbows, knees, and ankles67. Osteoarthritis causes pain, stiffness, swelling, and reduced joint function, while rheumatoid arthritis causes pain, stiffness, swelling, warmth, redness, and deformity of the joints, as well as systemic symptoms, such as fatigue, fever, and anemia67. Osteoarthritis is diagnosed by clinical examination, X-rays, and sometimes joint fluid analysis, while rheumatoid arthritis is diagnosed by clinical examination, blood tests, and sometimes imaging tests67.
- The treatment alternatives for osteoarthritis include non-pharmacological and pharmacological options. Non-pharmacological options include lifestyle modifications, such as weight loss, exercise, physical therapy, occupational therapy, supportive devices, and avoiding activities that worsen the pain18. Pharmacological options include medications, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), duloxetine, and corticosteroid injections, and surgery, such as joint replacement, when other treatments fail18. For the patient in the case, a combination of non-pharmacological and pharmacological options may be appropriate, depending on the severity of her symptoms, her preferences, and her medical history. For example, she may benefit from weight loss, exercise, physical therapy, NSAIDs, and corticosteroid injections, but she may need to avoid NSAIDs if she has a history of stomach ulcers or bleeding problems.
- Osteoporosis is a condition that causes the bones to become weak and brittle, increasing the risk of fractures9. To handle the patient’s concern about osteoporosis, the following interventions and education may be provided:
- Assess the patient’s bone density and fracture risk using a bone density test, such as a dual-energy X-ray absorptiometry (DEXA) scan, and a risk assessment tool, such as the FRAX calculator910.
- Advise the patient to quit smoking, limit alcohol consumption, maintain a healthy weight, eat a well-balanced diet rich in calcium and vitamin D, and stay active911.
- Prescribe medications that can help prevent or treat osteoporosis, such as bisphosphonates, hormone therapy, denosumab, or calcitonin, depending on the patient’s risk factors, preferences, and contraindications912.
- Provide education on the signs and symptoms of osteoporosis, the importance of regular follow-up and adherence to treatment, the possible side effects of medications, and the prevention of falls and fractures913.
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time
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